Pelvic floor disorders are common problems facing women, and many do not seek medical help. These disorders can result from a variety of medical conditions as well as normal changes associated with childbirth and aging.

Pelvic floor disorders may cause sexual dysfunction, vaginal pain or discomfort, fecal/urinary incontinence and abdominal discomfort. Many women experience significant changes in daily activities and even self-identify because of these conditions.

Let’s discuss some of these disorders and treatment options.

Pelvic Organ Prolapse

A woman’s pelvic organs (bladder, uterus, rectum) and the vagina are supported by muscles and connective tissue in the pelvic floor. When the muscles and tissue weaken, the support for these organs and the vagina also weaken, resulting in pelvic organ prolapse. When this occurs, women can feel a sensation of strong pressure or a bulge coming from the vaginal opening. Prolapse can also affect the way you urinate. If the prolapse is bothersome or affects the way you urinate, treatment options include physical therapy, a pessary device fitted by your doctor or surgery.

Overactive Bladder

Overactive bladder causes a sudden urge to urinate which may be difficult to stop, and this may lead to the involuntary loss of urine. If you have an overactive bladder, you may feel embarrassed, resulting in a need to isolate yourself or limit your social life. The good news is that a consultation with a urogynecologist can determine if there's a specific cause for your symptoms.

Treatment options include medications. Management of overactive bladder often begins with diet and behavioral strategies and timed voiding and bladder training techniques using your pelvic floor (e.g. Kegel exercises). Keeping a log of how frequently you urinate, leakage episodes and the type and amount of fluids you take in is helpful. Limiting consumption of caffeine, alcohol and artificial sweeteners is also recommended.

Recurrent Urinary Tract Infections

A urinary tract infection (UTI) occurs when bacteria infect any part of the urinary system. Factors that increase the risk include menopause, sexual intercourse, a new sexual partner and the use of spermicide or a diaphragm for contraception. Typical symptoms include burning on urination, increased frequency to urinate and a strong urgency to urinate.

Some women get UTIs multiple times a year and treatment commonly includes antibiotics. However, there are steps that you can take in consultation with your doctor to help decrease the risk of receiving UTIs. For menopausal women, vaginal estrogen or a small dose of antibiotics that can be taken daily for several months or after intercourse may be prescribed.